[BN] the know

Working to curb the obesity epidemic

“We sit down and develop an individual plan, something the patient is invested in and willing to work on.” – Candi Possinger, left, and Kendra Hennessey, both from Catholic Medical Partners John Hickey/Buffalo News

When it comes to obesity in Western New York, there’s good news and bad news.

The good news: Those on the front lines see falling rates of obesity in preschoolers, mirroring a national trend.

The bad news: Those rates, as well as obesity in all other age ranges, continue at epidemic proportions.

“With so many chronic diseases, the center point you can tie back to is obesity,” said Candi Possinger, a registered dietitian and manager of nutrition services with Catholic Medical Partners, the doctor arm of the regional Catholic Health System.

“We’re seeing these chronic diseases happening at a younger age because of the obesity epidemic,” Possinger said. “Never before would I see a 5-year-old with off-the-charts cholesterol levels and diabetes and things that we’re seeing now because, unfortunately, this child might have been obese since age 2. So these diseases we’ve always thought of as adult onset, we’re seeing in adolescents and children.”

Possinger, 40, grew up outside Albany, and came to Western New York at the behest of her then-boyfriend and now husband, Brian Possinger, a Buffalo native and graduate of the Albany School of Pharmacy. He asked her to come for a year, and register in the first dietetics program at the University at Buffalo. That was 14 years ago.

The Buffalo transplant has been an adjunct professor in the UB Department of Exercise and Nutrition Science for almost that long and teaches part time at D’Youville College. She became a certified diabetes educator several years ago while working at Mount St. Mary’s Hospital in Lewiston.

Catholic Medical Partners saw a need 3½ years ago to plug dietetics into its primary care treatment regimen and hired Possinger. Today, she leads a staff that includes an assistant and 10 dietitians who work with 47 practices. There is no extra medical charge, not even a co-pay, for those who avail themselves of their services.

Can you quantify the epidemic?

March 6, the new maps came out for obesity rates in the States. We’re talking about millions and millions of people. A couple of weeks ago, it was reported that obesity rates went down from 11 percent to 8 percent for adolescents aged 2 to 5, but that’s still one in every almost 12 kids. If you go to adulthood, you’re talking one in every seven or eight, if not even a little bit higher.

Catholic Health has a strong bariatric program. Individuals for bariatric surgery generally have to have a Body Mass Index of 40 or greater, so you’re talking normally 300-pounds plus. When I started in the field, there was only one bariatric program locally. Now there are five, and they all have a waiting list. If you take the obesity maps that the (Centers for Disease Control and Prevention) puts out and you put the diabetes maps on top of them, they’re almost the same. We’re not just seeing a person who needs to lose weight. Often, that person has high cholesterol, diabetes, congestive heart failure, all these other issues due to the excess weight they’re carrying around.

How did they gain so much weight?

Many don’t know. They didn’t gain 100 pounds in six months. It’s ‘I gained 5 pounds this year and 10 pounds last year,’ and when they’re ready to face the problem, they have 200 pounds to get off their body. … Unfortunately, for many, it’s not until they have other health problems where they say, ‘I need to do something about this now.’ Or it’s another motivating factor: ‘My child’s getting married,’ or ‘I’m having a grandchild.’ The unfortunate thing is they’re forgetting how long it took the weight to go on, so they’re looking to us to get 200 pounds off in a month. It’s not going to happen.

We focus one-on-one with the patients. We sit down and develop an individual plan, something the patient is invested in and willing to work on; small changes, the kind that can eventually lead to the big weight loss they’re looking for. We try to look at the whole picture: ‘Yes you need to lose weight, but you also need to get your blood pressure down and your blood sugar under control.’ We start a lot with portion control and timing of meals. You will not believe the amount of people who are overweight and go long hours skipping meals. They’ll say, ‘I don’t eat a lot throughout the day … and I’m gaining weight.’ I always explain it like a gas pedal. If I put smooth pressure on my gas pedal, my car rides smoothly. If I slam it up and down, it doesn’t move so smoothly.

What do you make of the child obesity rates falling for preschoolers yet continuing at about the same levels for others?

If you look at how important nutrition and health has become for the media and in general over the last five to 10 years, my hope is that’s what we’re starting to see now in families. So the parents are starting to focus more on health, and even those that maybe are struggling with weight issues themselves are instilling these healthier habits so that now their children, ages 2 to 5, are eating healthier and understanding better. I have a 7-year-old (son Lucas) and it’s sometimes amazing to me what he will echo from me. … These people are moving through that 2 to 5 age group, so the hope is that we’re going to continue to have lower obesity rates through the age gamuts.

Are you recommending food changes and exercise?

Out of two to three goals, we try to have one goal deal with activity, exercise, and the other two goals deal with nutrition.

It could be when they’re eating, what they’re eating, how much they’re eating. It depends on where the problem is.